Bill > S03365

This bill amends the New York Public Health Law to establish clear guidelines for the payment of claims submitted by healthcare agencies such as home care services agencies, certified home health agencies, and long-term home health care programs. The bill defines a "clean claim" as a properly submitted healthcare service payment request and mandates specific timelines and procedures for claim processing. Payors must now pay clean claims within 30 days if submitted electronically or 45 days if submitted by paper or fax. If a claim has disputed portions, the payor must notify the provider within 15 calendar days, specifying exactly what additional information is needed. The bill also imposes penalties for non-compliance, including mandatory full payment plus interest (at either the state corporate tax rate or 12% per annum) for any violations. Each improperly processed claim is considered a separate violation, which provides a strong incentive for healthcare payors to process claims accurately and promptly. The goal of the legislation appears to be improving the efficiency and transparency of healthcare claim payments, reducing delays, and ensuring healthcare providers are compensated in a timely manner.

Health and Social Services

https://www.nysenate.gov/legislation/bills/2025/S3365